| NPI | 1043774789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4450) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2019002633) |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2025-05-22 |